Gastrointestinal Diseases

• GERD – gastroesophageal reflux disease
• Barretts Esophagus
• Peptic Ulcer Disease
• Hepatitis
• Inflammatory Bowel Disease (IBD) (Crohn’s and Ulcerative Colitis)
• Irritable Bowel Syndrome (IBS)
• Hemorrhoids
• Diverticulosis
• Celiac Disease

GERD
The acronym GERD stands for GastroEsophageal Reflux Disease, often referred to as "reflux". Gastroesophageal reflux is the term used to describe a backflow of stomach acid from the stomach into the swallowing tube or esophagus. The principal symptom is heartburn, an uncomfortable burning sensation behind the breastbone, most commonly occurring after a meal or with lying down at night. If left untreated, GERD can cause inflammation of the esophagus (esophagitis), ulcers in the esophagus, swallowing difficulties due to narrowing (stricture), or more serious complications, such as Barrett’s Esophagus. Studies suggest that people suffering from long term (chronic) GERD may be at a higher risk of a specific type of esophageal cancer. Treatment of GERD may include diet and lifestyle changes, as well as medications. It is usually a lifelong disorder.

For more information, you may visit the following websites:
www.askasge.org/pages/brochures/barretts_patient.cfm
www.acg.gi.org/patients/pdfs/UnderstandGERD.pdf
www.acg.gi.org/patients/patientinfo/gerd.asp
www.digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.htm
www.mayoclinic.com/health/gerd/DS00967

Barrett's Esophagus
Barrett's Esophagus is a precancerous condition that complicates chronic untreated GERD. The repeated backflow of stomach acid into the esophagus can cause a transformation of the lining of the esophagus to a new lining with precancerous intestinal cells.
People with Barrett's Esophagus can be found in up to 15% of the people that undergo upper endoscopy (EGD). Because Barrett's cannot be detected by a blood test or x-ray, EGD is needed to diagnose it in patients at risk. Biopsies taken during an EGD can help identify the precancerous cells so that the progression to cancer can be monitored and halted.

For more information, you may visit the following websites
www.askasge.org/pages/brochures/barretts_patient.cfm
www.barrettsinfo.com/
www.digestive.niddk.nih.gov/ddiseases/pubs/barretts/index.htm

Peptic Ulcer Disease
Peptic Ulcer Disease (PUD) occurs when stomach acid penetrates the stomach or duodenal causing sores. One major cause is a bacterium called Helicobacter Pylori (H. Pylori). Your doctor can prescribe antibiotics that treat H. Pylori. A second cause of ulcers is regular use of Non-Steroidal Anti-inflammatory Drugs (NSAIDS e.g. Celebrex, Aspirin, BC or Goody powder, Advil, Motrin, Nuprin, Aleve) that are commonly used for pain relief. Often, people who develop ulcers on these medications do not have typical symptoms of pain, nausea or vomiting. Because ulcers can be caused by regular use of NSAIDS, if you are taking over-the-counter pain medications on a regular basis, you should talk with your physician about the potential for ulcers and other GI side effects. Symptoms of ulcers include abdominal pain, nausea or vomiting. Serious complications include bleeding, perforation or obstruction. REMEMBER, about half the people who present with a perforated or bleeding ulcer do not report any other prior symptoms. Ulcers can be healed with medications that can decrease acid production and sometimes these medications need to be taken lifelong, esp. if ulcer was complicated by bleeding or perforation. H. Pylori induced ulcers can be cured in 85-90% people by a course of antibiotics.

For more information, you may visit the following website
www.acg.gi.org/patients/patientinfo/ulcers.asp
www.digestive.niddk.nih.gov/ddiseases/pubs/hpylori/index.htm

Hepatitis
Hepatitis is inflammation of the liver. It can be caused by alcohol abuse, viral infections (such as Hepatitis A, B or C), auto immune disease or metabolic inherited disorders. Significant hepatitis can cause Jaundice (yellow coloring of the skin). Prolonged untreated hepatitis can cause permanent liver cell damage and scarring of the liver, leading to cirrhosis, liver failure and liver cancer.

For more information on all types of Hepatitis, you may visit the following websites:
Hepatitis A
Hepatitis B
Hepatitis C
Liver Cancer
Hemochromatosis
Liver Transplantation
www.digestive.niddk.nih.gov/ddiseases/topics/hepatitis.asp

Inflammatory Bowel Disease
Inflammatory Bowel Disease (IBD) is a general term used to describe chronic diseases that cause swelling and inflammation of the walls of the digestive tract. The two types of IBD are Crohn's Disease (Crohn's), and Ulcerative Colitis (UC). Most patients who suffer from either form of IBD have alternating periods of relative health alternating with periods of disease, though some patients have continuous symptoms from continued inflammation. Symptoms include diarrhea with or without blood, abdominal pain, and weight loss.

The severity of the disease varies between individuals. Some suffer only mild symptoms, which are little more than a nuisance, while others have severe and disabling symptoms which are a serious threat to their health. Medical science has not yet discovered a cure, but numerous medications are now available to control symptoms with many more on the horizon.

Visit the Colitis foundation for more information:
www.ccfa.org/info/?LMI=3
www.digestive.niddk.nih.gov/ddiseases/pubs/crohns/index.htm - Crohn’s Disease
www.digestive.niddk.nih.gov/ddiseases/pubs/colitis/index.htm - Ulcerative Colitis

Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome is a disorder of the gastrointestinal (GI) tract characterized by abdominal pain associated with alterations in bowel function, diarrhea, constipation or both, typically over months or years, in the absence of inflammation. The cause is unknown but believed to involve abnormal contractions of the bowel and/or a heightened perception to stimuli from the bowel. Treatment for IBS may include diet, medication, exercise, or some combination of the three.

For more information visit the following web pages:
www.acg.gi.org/patients/ibsrelief/IBS.pdf
www.digestive.niddk.nih.gov/ddiseases/pubs/ibs/index.htm

Hemorrhoids
Hemorrhoids are cushions of swollen veins in the anal canal that often cause discomfort. Symptoms include pain, itching, burning, and bleeding. Constipation is a major cause of hemorrhoids, though hemorrhoids may also be caused by sitting or standing for long periods of time. Several over-the-counter measures to treat hemorrhoids are available. These include: Ibuprofen for pain, warm Sitz baths, stool softeners, aloe wipes, creams, and drinking 64 ounces of water daily. Large Internal hemorrhoids causing severe symptoms may be treated with band ligation, coagulation, or surgical resection.

For more information, visit the following web page:
www.digestive.niddk.nih.gov/ddiseases/pubs/hemorrhoids/index.htm

Diverticulosis
Diverticulosis coli is a condition of the colon. Diverticula are small pouches that bulge outward through weakened areas in the colon. The pouches can be formed when pressure inside the colon builds,. Most patients with diverticulosis have no symptoms. If the pouches become inflamed, the condition is called diverticulitis.
Diverticulitis is usually associated with symptoms such as lower abdominal pain, fever, tenderness, and a change in the shape of the stool. A patient with diverticulosis may never develop diverticulitis, but should diverticulitis occur, the patient should immediately see a physician. The physician may treat the patient with antibiotics and a modified diet. Rarely diverticulitis may require hospitalization, emergency surgery or obstruction of the colon. Lower GI bleeding is another uncommon but serious complication of diverticulosis. It typically presents with painless, large volume rectal bleeding and is self limited in majority of cases.

Please visit the following website for more information:
www.acg.gi.org/patients/gihealth/diverticular.asp
www.digestive.niddk.nih.gov/ddiseases/pubs/diverticulosis/index.htm

Celiac Disease
Celiac disease is a condition in which there is a chronic reaction to certain protein chains, commonly referred to as glutens, found in some cereal grains, primarily Wheat, Rye and Barley. This reaction causes destruction of the villi in the small intestine, resulting in malabsorption of nutrients. It is estimated that approximately two million Americans suffer from this condition.

Please visit the following pages for more information:
www.acg.gi.org/patients/gihealth/celiac.asp
www.digestive.niddk.nih.gov/ddiseases/pubs/celiac/index.htm
Celiac Disease Foundation - www.celiac.org.